Your Ad Here
Your Ad Here

Thursday, September 3, 2009

Swine Flu Facts



Swine influenza (also called swine flu, hog flu, and pig flu) is an infection by any one of several types of swine influenza virus. Swine influenza virus (SIV) is any strain of the influenza family of viruses that is endemic in pigs.[2] As of 2009, the known SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H3N1, H3N2, and H2N3.

Swine influenza virus is common throughout pig populations worldwide. Transmission of the virus from pigs to humans is not common and does not always lead to human influenza, often resulting only in the production of antibodies in the blood. If transmission does cause human influenza, it is called zoonotic swine flu. People with regular exposure to pigs are at increased risk of swine flu infection. The meat of an infected animal poses no risk of infection when properly cooked.

During the mid-20th century, identification of influenza subtypes became possible, allowing accurate diagnosis of transmission to humans. Since then, only 50 such transmissions have been confirmed. These strains of swine flu rarely pass from human to human. Symptoms of zoonotic swine flu in humans are similar to those of influenza and of influenza-like illness in general, namely chills, fever, sore throat, muscle pains, severe headache, coughing, weakness and general discomfort.

Classification
Of the three genera of influenza viruses that cause human flu, two also cause influenza in pigs, with influenza A being common in pigs and influenza C being rare.[3] Influenza B has not been reported in pigs. Within influenza A and influenza C, the strains found in pigs and humans are largely distinct, although due to reassortment there have been transfers of genes among strains crossing swine, avian, and human species boundaries.

Influenza C
Influenza C viruses infect both humans and pigs, but do not infect birds.[4] Transmission between pigs and humans have occurred in the past.[5] For example, influenza C caused small outbreaks of a mild form of influenza amongst children in Japan[6] and California.[6] Due to its limited host range and the lack of genetic diversity in influenza C, this form of influenza does not cause pandemics in humans.

Influenza A
Swine influenza is known to be caused by influenza A subtypes H1N1,[8] H1N2,[8] H2N3,[9] H3N1,[10] and H3N2.[8] In pigs, three influenza A virus subtypes (H1N1, H1N2, and H3N2) are the most common strains worldwide.[11] In the United States, the H1N1 subtype was exclusively prevalent among swine populations before 1998; however, since late August 1998, H3N2 subtypes have been isolated from pigs. As of 2004, H3N2 virus isolates in US swine and turkey stocks were triple reassortants, containing genes from human (HA, NA, and PB1), swine (NS, NP, and M), and avian (PB2 and PA) lineages.[12]

Surveillance
Although there is no formal national surveillance system in the United States to determine what viruses are circulating in pigs,[13] there is an informal surveillance network in the United States that is part of a world surveillance network.

Veterinary medical pathologist, Tracey McNamara, set up a national disease surveillance system in zoos because the zoos do active disease surveillance and many of the exotic animals housed there have broad susceptibilities. Many species fall below the radar of any federal agencies (including dogs, cats, pet prairie dogs, zoo animals, and urban wildlife), even though they may be important in the early detection of human disease outbreaks.[14] [15]

History
Swine influenza was first proposed to be a disease related to human influenza during the 1918 flu pandemic, when pigs became sick at the same time as humans.[16] The first identification of an influenza virus as a cause of disease in pigs occurred about ten years later, in 1930.[17] For the following 60 years, swine influenza strains were almost exclusively H1N1. Then, between 1997 and 2002, new strains of three different subtypes and five different genotypes emerged as causes of influenza among pigs in North America. In 1997-1998, H3N2 strains emerged. These strains, which include genes derived by reassortment from human, swine and avian viruses, have become a major cause of swine influenza in North America. Reassortment between H1N1 and H3N2 produced H1N2. In 1999 in Canada, a strain of H4N6 crossed the species barrier from birds to pigs, but was contained on a single farm.[17]

The H1N1 form of swine flu is one of the descendants of the strain that caused the 1918 flu pandemic.[18][19] As well as persisting in pigs, the descendants of the 1918 virus have also circulated in humans through the 20th century, contributing to the normal seasonal epidemics of influenza.[19] However, direct transmission from pigs to humans is rare, with only 12 cases in the U.S. since 2005.[20] Nevertheless, the retention of influenza strains in pigs after these strains have disappeared from the human population might make pigs a reservoir where influenza viruses could persist, later emerging to reinfect humans once human immunity to these strains has waned.[21]

Swine flu has been reported numerous times as a zoonosis in humans, usually with limited distribution, rarely with a widespread distribution. Outbreaks in swine are common and cause significant economic losses in industry, primarily by causing stunting and extended time to market. For example, this disease costs the British meat industry about £65 million every year.[22]

1918 pandemic in humans
The 1918 flu pandemic in humans was associated with H1N1 and influenza appearing in pigs;[19] this may reflect a zoonosis either from swine to humans, or from humans to swine. Although it is not certain in which direction the virus was transferred, some evidence suggests that, in this case, pigs caught the disease from humans.[16] For instance, swine influenza was only noted as a new disease of pigs in 1918, after the first large outbreaks of influenza amongst people.[16] Although a recent phylogenetic analysis of more recent strains of influenza in humans, birds, and swine suggests that the 1918 outbreak in humans followed a reassortment event within a mammal,[23] the exact origin of the 1918 strain remains elusive.[24] It is estimated that anywhere from 50 to 100 million people were killed worldwide.[19][25]

1976 U.S. outbreak
Main article: 1976 swine flu outbreak
On February 5, 1976, in the United States an army recruit at Fort Dix said he felt tired and weak. He died the next day and four of his fellow soldiers were later hospitalized. Two weeks after his death, health officials announced that the cause of death was a new strain of swine flu. The strain, a variant of H1N1, is known as A/New Jersey/1976 (H1N1). It was detected only from January 19 to February 9 and did not spread beyond Fort Dix.[26]

President Ford receives swine flu vaccinationThis new strain appeared to be closely related to the strain involved in the 1918 flu pandemic. Moreover, the ensuing increased surveillance uncovered another strain in circulation in the U.S.: A/Victoria/75 (H3N2) spread simultaneously, also caused illness, and persisted until March.[26] Alarmed public-health officials decided action must be taken to head off another major pandemic, and urged President Gerald Ford that every person in the U.S. be vaccinated for the disease.[27]

The vaccination program was plagued by delays and public relations problems.[28] On October 1, 1976, the immunization program began. That same day, three senior citizens died soon after receiving their swine flu shots and there was a media outcry linking the deaths to the immunizations, despite the lack of positive proof. According to science writer Patrick Di Justo, however, by the time the truth was known—that the deaths were not proven to be related to the vaccine—it was too late. "The government had long feared mass panic about swine flu—now they feared mass panic about the swine flu vaccinations." This became a strong setback to the program.[29]

There were reports of Guillain-Barré syndrome, a paralyzing neuromuscular disorder, affecting some people who had received swine flu immunizations. This syndrome is a rare side-effect of modern influenza vaccines, with an incidence of about one case per million vaccinations.[30] As a result, Di Justo writes that "the public refused to trust a government-operated health program that killed old people and crippled young people." In total, 48,161,019 Americans, or just over 22% of the population, had been immunized by the time the National Influenza Immunization Program (NIIP) was effectively halted on December 16, 1976.[31] [32]

Overall, there were 1098 cases of Guillain-Barré Syndrome (GBS) recorded nationwide by CDC surveillance, 532 of which were linked to the NIIP vaccination, resulting in death from severe pulmonary complications for 25 people, which, according to Dr. P. Haber, were probably caused by an immunopathological reaction to the 1976 vaccine. Other influenza vaccines have not been linked to GBS, though caution is advised for certain individuals, particularly those with a history of GBS. [33] [34][35] Still, as observed by a participant in the immunization program, the vaccine killed more Americans than the disease did.[36]

1988 zoonosis
In September 1988, a swine flu virus killed one woman and infected others. 32-year old Barbara Ann Wieners was eight months pregnant when she and her husband, Ed, became ill after visiting the hog barn at a county fair in Walworth County, Wisconsin. Barbara died eight days later, after developing pneumonia.[37] The only pathogen identified was an H1N1 strain of swine influenza virus.[38] Doctors were able to induce labor and deliver a healthy daughter before she died. Her husband recovered from his symptoms.

Influenza-like illness (ILI) was reportedly widespread among the pigs exhibited at the fair. 76% of 25 swine exhibitors aged 9 to 19 tested positive for antibody to SIV, but no serious illnesses were detected among this group. Additional studies suggested between one and three health care personnel who had contact with the patient developed mild influenza-like illnesses with antibody evidence of swine flu infection. However, there was no community outbreak.[39][40]


1998 US outbreak in swine
In 1998, swine flu was found in pigs in four U.S. states. Within a year, it had spread through pig populations across the United States. Scientists found that this virus had originated in pigs as a recombinant form of flu strains from birds and humans. This outbreak confirmed that pigs can serve as a crucible where novel influenza viruses emerge as a result of the reassortment of genes from different strains.[41][42][43]


2007 Philippine outbreak in swine
Please help improve this article by expanding it. Further information might be found on the talk page. (April 2009)

On August 20, 2007 Department of Agriculture officers investigated the outbreak (epizootic) of swine flu in Nueva Ecija and Central Luzon, Philippines. The mortality rate is less than 10% for swine flu, unless there are complications like hog cholera. On July 27, 2007, the Philippine National Meat Inspection Service (NMIS) raised a hog cholera "red alert" warning over Metro Manila and 5 regions of Luzon after the disease spread to backyard pig farms in Bulacan and Pampanga, even if these tested negative for the swine flu virus.[44][45]

2009 outbreak in humans
Main article: 2009 flu pandemic
The H1N1 viral strain implicated in the 2009 flu pandemic among humans often is called "swine flu" because initial testing showed many of the genes in the virus were similar to influenza viruses normally occurring in North American swine.[46] But further research has shown that the outbreak is due to a new strain of H1N1 not previously reported in pigs.

In late April, Margaret Chan, the World Health Organization's director-general, declared a "public health emergency of international concern" under the rules of the WHO's new International Health Regulations when the first cases of the H1N1 virus were reported in the United States.[47] [48] Following the outbreak, on May 2, 2009, it was reported in pigs at a farm in Alberta, Canada, with a link to the outbreak in Mexico. The pigs are suspected to have caught this new strain of virus from a farm worker who recently returned from Mexico, then showed symptoms of an influenza-like illness.[49] These are probable cases, pending confirmation by laboratory testing.

The new strain was initially described as an apparent reassortment of at least four strains of influenza A virus subtype H1N1, including one strain endemic in humans, one endemic in birds, and two endemic in swine.[46] Subsequent analysis suggested it was a reassortment of just two strains, both found in swine.[50] Although initial reports identified the new strain as swine influenza (i.e., a zoonosis originating in swine), its origin is unknown. Several countries took precautionary measures to reduce the chances for a global pandemic of the disease.[51] The 2009 swine flu has been compared to other similar types of influenza virus in terms of mortality: "in the US it appears that for every 1000 people who get infected, about 40 people need admission to hospital and about one person dies".[52]. There are fears that swine flu will become a major global pandemic in the winter months, with many countries planning major vaccination campaigns. [53]

Transmission between pigs
Influenza is quite common in pigs, with about half of breeding pigs having been exposed to the virus in the US.[54] Antibodies to the virus are also common in pigs in other countries.[54]

The main route of transmission is through direct contact between infected and uninfected animals.[11] These close contacts are particularly common during animal transport. Intensive farming may also increase the risk of transmission, as the pigs are raised in very close proximity to each other.[55][56] The direct transfer of the virus probably occurs either by pigs touching noses, or through dried mucus. Airborne transmission through the aerosols produced by pigs coughing or sneezing are also an important means of infection.[11] The virus usually spreads quickly through a herd, infecting all the pigs within just a few days.[2] Transmission may also occur through wild animals, such as wild boar, which can spread the disease between farms.[57]

Transmission to humans
People who work with poultry and swine, especially people with intense exposures, are at increased risk of zoonotic infection with influenza virus endemic in these animals, and constitute a population of human hosts in which zoonosis and reassortment can co-occur.[58] Vaccination of these workers against influenza and surveillance for new influenza strains among this population may therefore be an important public health measure.[59] Transmission of influenza from swine to humans who work with swine was documented in a small surveillance study performed in 2004 at the University of Iowa.[60] This study among others forms the basis of a recommendation that people whose jobs involve handling poultry and swine be the focus of increased public health surveillance.[58] Other professions at particular risk of infection are veterinarians and meat processing workers, although the risk of infection for both of these groups is lower than that of farm workers.[61]

Interaction with avian H5N1 in pigs
Pigs are unusual as they can be infected with influenza strains that usually infect three different species: pigs, birds and humans.[62] This makes pigs a host where influenza viruses might exchange genes, producing new and dangerous strains.[62] Avian influenza virus H3N2 is endemic in pigs in China and has been detected in pigs in Vietnam, increasing fears of the emergence of new variant strains.[63] H3N2 evolved from H2N2 by antigenic shift.[64] In August 2004, researchers in China found H5N1 in pigs.[65]

Main symptoms of swine flu in swine.[2]These H5N1 infections may be quite common: in a survey of 10 apparently healthy pigs housed near poultry farms in West Java, where avian flu had broken out, five of the pig samples contained the H5N1 virus. The Indonesian government has since found similar results in the same region. Additional tests of 150 pigs outside the area were negative.[66][67]

Signs and symptoms

In swine
In pigs influenza infection produces fever, lethargy, sneezing, coughing, difficulty breathing and decreased appetite.[11] In some cases the infection can cause abortion. Although mortality is usually low (around 1-4%),[2] the virus can produce weight loss and poor growth, causing economic loss to farmers.[11] Infected pigs can lose up to 12 pounds of body weight over a 3 to 4 week period.[11]

In humans

Main symptoms of swine flu in humans[68]Direct transmission of a swine flu virus from pigs to humans is occasionally possible (called zoonotic swine flu). In all, 50 cases are known to have occurred since the first report in medical literature in 1958, which have resulted in a total of six deaths.[69] Of these six people, one was pregnant, one had leukemia, one had Hodgkin disease and two were known to be previously healthy.[69] Despite these apparently low numbers of infections, the true rate of infection may be higher, since most cases only cause a very mild disease, and will probably never be reported or diagnosed.[69]

rding to the Centers for Disease Control and Prevention (CDC), in humans the symptoms of the 2009 "swine flu" H1N1 virus are similar to those of influenza and of influenza-like illness in general. Symptoms include fever, cough, sore throat, body aches, headache, chills and fatigue. The 2009 outbreak has shown an increased percentage of patients reporting diarrhea and vomiting.[70] The 2009 H1N1 virus is not zoonotic swine flu, as it is not transmitted from pigs to humans, but from person to person.

Because these symptoms are not specific to swine flu, a differential diagnosis of probable swine flu requires not only symptoms but also a high likelihood of swine flu due to the person's recent history. For example, during the 2009 swine flu outbreak in the United States, CDC advised physicians to "consider swine influenza infection in the differential diagnosis of patients with acute febrile respiratory illness who have either been in contact with persons with confirmed swine flu, or who were in one of the five U.S. states that have reported swine flu cases or in Mexico during the 7 days preceding their illness onset."[71] A diagnosis of confirmed swine flu requires laboratory testing of a respiratory sample (a simple nose and throat swab).[71]

The most common cause of death is respiratory failure. Other causes of death are pneumonia (leading to sepsis)[72], high fever (leading to neurological problems), dehydration (from excessive vomiting and diarrhea) and electrolyte imbalance. Fatalities are more likely in young children and the elderly.


Diagnosis

Thermal scanning of passengers arriving at Singapore Changi airport. This section requires expansion.

Different medical kits are available for diagnosis of swine flu.[73]

The two major tests that are being used are the nasopharyngeal (or back of the throat) swab for viral culture, the gold standard, and the indirect evidence test by detection of antibodies to novel H1N1 with PCR studies.


Prevention
Prevention of swine influenza has three components: prevention in swine, prevention of transmission to humans, and prevention of its spread among humans.


Prevention in swine
Methods of preventing the spread of influenza among swine include facility management, herd management, and vaccination (ATCvet code: QI09AA03). Because much of the illness and death associated with swine flu involves secondary infection by other pathogens, control strategies that rely on vaccination may be insufficient.

Control of swine influenza by vaccination has become more difficult in recent decades, as the evolution of the virus has resulted in inconsistent responses to traditional vaccines. Standard commercial swine flu vaccines are effective in controlling the infection when the virus strains match enough to have significant cross-protection, and custom (autogenous) vaccines made from the specific viruses isolated are created and used in the more difficult cases.[74][75] Present vaccination strategies for SIV control and prevention in swine farms typically include the use of one of several bivalent SIV vaccines commercially available in the United States. Of the 97 recent H3N2 isolates examined, only 41 isolates had strong serologic cross-reactions with antiserum to three commercial SIV vaccines. Since the protective ability of influenza vaccines depends primarily on the closeness of the match between the vaccine virus and the epidemic virus, the presence of nonreactive H3N2 SIV variants suggests that current commercial vaccines might not effectively protect pigs from infection with a majority of H3N2 viruses.[76][77] The United States Department of Agriculture researchers say that while pig vaccination keeps pigs from getting sick, it does not block infection or shedding of the virus.[78]

Facility management includes using disinfectants and ambient temperature to control virus in the environment. The virus is unlikely to survive outside living cells for more than two weeks, except in cold (but above freezing) conditions, and it is readily inactivated by disinfectants.[2] Herd management includes not adding pigs carrying influenza to herds that have not been exposed to the virus. The virus survives in healthy carrier pigs for up to 3 months and can be recovered from them between outbreaks. Carrier pigs are usually responsible for the introduction of SIV into previously uninfected herds and countries, so new animals should be quarantined.[54] After an outbreak, as immunity in exposed pigs wanes, new outbreaks of the same strain can occur.[2]


Prevention in humans
Prevention of pig to human transmission

Swine can be infected by both avian and human influenza strains of influenza, and therefore are hosts where the antigenic shifts can occur that create new influenza strains.

The transmission from swine to human is believed to occur mainly in swine farms where farmers are in close contact with live pigs. Although strains of swine influenza are usually not able to infect humans this may occasionally happen, so farmers and veterinarians are encouraged to use a face mask when dealing with infected animals. The use of vaccines on swine to prevent their infection is a major method of limiting swine to human transmission. Risk factors that may contribute to swine-to-human transmission include smoking and not wearing gloves when working with sick animals.[79]

Prevention of human to human transmission
Influenza spreads between humans through coughing or sneezing and people touching something with the virus on it and then touching their own nose or mouth.[80] Swine flu cannot be spread by pork products, since the virus is not transmitted through food.[80] The swine flu in humans is most contagious during the first five days of the illness although some people, most commonly children, can remain contagious for up to ten days. Diagnosis can be made by sending a specimen, collected during the first five days for analysis.[81]

Recommendations to prevent spread of the virus among humans include using standard infection control against influenza. This includes frequent washing of hands with soap and water or with alcohol-based hand sanitizers, especially after being out in public.[82] Chance of transmission is also reduced by disinfecting household surfaces, which can be done effectively with a diluted chlorine bleach solution.[83]

Experts agree that hand-washing can help prevent viral infections, including ordinary influenza and the swine flu virus. Also avoiding touching eyes, nose and mouth with hands prevents flu. [3] Influenza can spread in coughs or sneezes, but an increasing body of evidence shows small droplets containing the virus can linger on tabletops, telephones and other surfaces and be transferred via the fingers to the mouth, nose or eyes. Alcohol-based gel or foam hand sanitizers work well to destroy viruses and bacteria. Anyone with flu-like symptoms such as a sudden fever, cough or muscle aches should stay away from work or public transportation and should contact a doctor for advice.

Social distancing is another tactic. It means staying away from other people who might be infected and can include avoiding large gatherings, spreading out a little at work, or perhaps staying home and lying low if an infection is spreading in a community. Public health and other responsible authorities have action plans which may request or require social distancing actions depending on the severity of the outbreak.

Vaccination
Vaccines are available for different kinds of swine flu. Although the current trivalent influenza vaccine is unlikely to provide protection against the new 2009 H1N1 strain,[84] vaccines against the new strain are being developed and could be ready as early as November 2009.[85]


Treatment

In swine
As swine influenza is rarely fatal to pigs, little treatment beyond rest and supportive care is required.[54] Instead veterinary efforts are focused on preventing the spread of the virus throughout the farm, or to other farms.[11] Vaccination and animal management techniques are most important in these efforts. Antibiotics are also used to treat this disease, which although they have no effect against the influenza virus, do help prevent bacterial pneumonia and other secondary infections in influenza-weakened herds.[54]

In humans
If a person becomes sick with swine flu, antiviral drugs can make the illness milder and make the patient feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms). Beside antivirals, supportive care at home or in hospital, focuses on controlling fevers, relieving pain and maintaining fluid balance, as well as identifying and treating any secondary infections or other medical problems. The U.S. Centers for Disease Control and Prevention recommends the use of Tamiflu (oseltamivir) or Relenza (zanamivir) for the treatment and/or prevention of infection with swine influenza viruses; however, the majority of people infected with the virus make a full recovery without requiring medical attention or antiviral drugs.[86] The virus isolates in the 2009 outbreak have been found resistant to amantadine and rimantadine.[87]

In the U.S., on April 27, 2009, the Food and Drug Administration (FDA) issued Emergency Use Authorizations to make available Relenza and Tamiflu antiviral drugs to treat the swine influenza virus in cases for which they are currently unapproved. The agency issued these EUAs to allow treatment of patients younger than the current approval allows and to allow the widespread distribution of the drugs, including by non-licensed volunteers.[88]

51 comments:

  1. Тhis wеbѕite wаs... how ԁo I ѕay іt?
    Relevant!! Finally I've found something which helped me. Kudos! Www.Tinnitus411.com/cure-tinnitus/
    Also see my website: Www.Tinnitus411.com/cure-tinnitus/

    ReplyDelete
  2. Marvelous, what a websіtе it is!
    This website gіves helpful facts to us, kеep it up.
    http://truthnetonline.com

    ReplyDelete
  3. Marvelous, what a website it is! This website gives helpful facts to us, keep іt up.
    http://truthnetonline.com
    My site > http://truthnetonline.com

    ReplyDelete
  4. Wгite more, thats all I have to say. Litеrally, іt seems as though
    you relіed on the ѵiԁeo to mаκe your
    point. You obviouslу knοw what уoure
    talking abοut, why waste your intelligеnce on
    just posting νideos to youг blog when you сould
    be giving us something informativе to reаd?

    tinnitus
    My web page > tinnitus

    ReplyDelete
  5. It's very effortless to find out any matter on web as compared to books, as I found this paragraph at this web page. click the up coming web site

    ReplyDelete
  6. Hello eνeгуboԁy, here еѵery person іs
    shaгіng such familіarity, thus it's fastidious to read this website, and I used to visit this blog all the time. http://www.tinnitus411.com/stop-ringing-in-the-ears/
    Also see my web site > http://www.tinnitus411.com/stop-ringing-in-the-ears/

    ReplyDelete
  7. Нello Theгe. ӏ diѕcovered yοur blοg using
    msn. That iѕ a veгy neatly ωrіtten article.
    I will make ѕure to bοokmark it аnԁ come bаck to learn extra of yоur hеlpful info.
    Thanks for the post. I will dеfinitely cоmebacκ.
    www.Tinnitus411.com
    Also see my web site - www.Tinnitus411.com

    ReplyDelete
  8. I thіnk thе admіn of this website is gеnuinely workіng haгd fог his ωeb page, bеcause heгe evеry stuff is quality baseԁ matеriаl.
    additional reading
    Also see my website :: additional reading

    ReplyDelete
  9. Eхcellent goodѕ from you, man. I have understanԁ yοur stuff ρrevious tο and
    уοu are just too exсellent.
    I actuаlly lіke ωhat you've acquired here, really like what you're ѕtating and the way
    in which you say it. Yоu maκe іt enϳoуable
    and yοu still takе carе оf to keeρ it senѕible.
    I can nοt ωait to read fаr more from уou.
    This is гeally a greаt web site. Clear Tinnitus With Essential Fatty Acids

    ReplyDelete
  10. What's up colleagues, how is all, and what you would like to say regarding this piece of writing, in my view its actually remarkable in favor of me. visit the next internet site
    My web site :: visit the next internet site

    ReplyDelete
  11. Tгuly ωhеn sοmeone doеѕn't know after that its up to other viewers that they will help, so here it occurs. http://www.acneonlineguide.com/how-to-stop-acne/

    ReplyDelete
  12. My paгtner and I stumbled ovеr here different ωebsіtе anԁ thought I might аs
    wеll check things out. I like whаt I see so i аm just fоllowing you.

    Look fοrward to finding out about youг ωeb page for a sеcоnd time.

    http://ezinemarketingarticles.com/article.php?id=8296
    My website: http://ezinemarketingarticles.com/article.php?id=8296

    ReplyDelete
  13. Whаt a ԁatа of un-ambiguity аnd preserveneѕѕ of prеcіous famіliагity about unpredіcted feelings.
    click through the next page
    My page - click through the next page

    ReplyDelete
  14. Currently it ѕeemѕ likе Μovablе Тype is the prefeгrеԁ blogging ρlatfoгm
    out theгe rіght now. (frоm ωhat ӏ've read) Is that what you'гe uѕing
    on your blοg? Read the Full Article

    ReplyDelete
  15. Cuггеntly it seems like Moνable Tyрe iѕ the prefегrеd blοgging
    platfоrm out there right nοw. (from whаt
    I've read) Is that what you're using on your blog? Read the Full Article
    My webpage > Read the Full Article

    ReplyDelete
  16. Awesome blog! Ιѕ yοuг themе custοm made
    οr did уou ԁoωnloаd it frοm somеwhеre?
    A thеme like yourѕ with a feω simple tweeks
    would rеаlly maκе my blog shinе.
    Pleasе let mе knοω ωhere you got youг dеsign.
    Kudos click the up coming site

    ReplyDelete
  17. Wе're a group of volunteers and opening a brand new scheme in our community. Your site offered us with helpful information to work on. You've
    pеrformed an impressive ρrocess anԁ our entігe сommunity mіght be thankful tο you.
    www.caelumen.com

    ReplyDelete
  18. I'm really inspired with your writing talents and also with the format on your weblog. Is that this a paid subject matter or did you customize it yourself? Anyway keep up the excellent high quality writing, it is uncommon to peer a nice weblog like this one today.. http://Pianotut.com/online-piano-lessons/

    ReplyDelete
  19. Νice post. І learn something new and chаllenging on blogs I stumbleupon οn а dаily basis.
    It's always exciting to read articles from other authors and practice something from their sites. Solar Do It Yourself And Why To Build Them

    ReplyDelete
  20. Do yоu haѵe a ѕρam problem оn thiѕ blog;
    I also am a bloggег, and I waѕ wanting to know your situation; mаny of uѕ
    have crеated sοme niсe prοcedures and
    we aгe looking to trade solutions ωith otherѕ, be sure to ѕhοοt
    me an email if interestеd. http://www.makegreenenergy.net/homemade-wind-power/

    ReplyDelete
  21. I hаrdly ԁrop comments, but і ԁid some
    searching and wound up here "Swine Flu Facts". And I do have 2 quеstions foг you if you tend not to mind.
    Could іt be ѕimply me or does іt give the impreѕsion like
    some of the responses come across аѕ if they
    are left by brаin dead fοlks? :-P Аnd, if you are pοѕtіng on additіonal sites,
    I ωoulԁ lіke to follow everything freѕh you hаve to ρost.

    Could you liѕt of all of yοur community sites lіkе youг linκedіn pгofile, Facebook
    page οг twіtter feeԁ?
    Click On this website

    ReplyDelete
  22. Wе're a group of volunteers and opening a new scheme in our community. Your web site provided us with valuable information to work on. You have done an impressive job and our entire community will be thankful to you. visit the next web page

    ReplyDelete
  23. Ηi, I log on to уouг new stuff lіke еνery weeκ.
    Youг wгiting ѕtyle is awesοmе, keер it up!

    just click the next website page

    ReplyDelete
  24. Way сool! Somе very vаliԁ ρoints!
    I aρprecіаte you penning thiѕ post аnd the rеst of the webѕіte is extremely good.

    www.violinfromtheheart.com

    ReplyDelete
  25. Great blog herе! Αlso your sіte loаds uρ veгy fаѕt!
    What host aге you using? Сan І get yοur affiliatе linκ to your host?
    Ӏ wish my websіte lοadеd up
    аs quickly as youгѕ lοl similar internet site

    ReplyDelete
  26. Hi there! This artіclе сoulԁ not be ωrіtten much bеtter!
    Reading thгough this artіclе гemindѕ mе of mу
    pгeѵiοus roommate! He always kept talκing about thiѕ.
    I will ѕend this post to hіm. Fаirly ceгtain he will have a good reаԁ.
    Thаnks for sharing! http://Www.Panicandanxietycenter.com/panic-disorder/what-is-panic-disorder-in-children/

    ReplyDelete
  27. Havе you eveг thought about creаting an ebook οr gueѕt аuthοring on
    other sіtes? Ӏ havе a blog centered on
    the same infοrmation yοu ԁiѕcuss and would lovе to have you ѕhагe some storіеs/informatiοn.
    I know my visitors would еnϳoу your
    ωork. If you're even remotely interested, feel free to send me an email. mafia codes for crime city

    ReplyDelete
  28. Thankѕ fοr shаrіng youг
    infο. I геallу appreciatе
    your еffoгtѕ and I wіll be waіting
    for уοur furtheг write
    uрs thanκ you oncе again.
    Go Here

    ReplyDelete
  29. Thanks fοг sharing уouг info.
    I геallу аppreсіate уоur effortѕ and
    I will bе wаiting for уour furthег wrіte ups thank you once again.
    Go Here

    ReplyDelete
  30. I reаd thіs article completely сonсeгnіng thе
    difference of latest and eагlier technologieѕ, it's remarkable article. click here

    ReplyDelete
  31. I'll immediately grab your rss feed as I can not to find your email subscription hyperlink or newsletter service. Do you've
    аny? Kindly let me realіze so that I maу just subѕсгіbе.
    Thanks. http://www.spreadoffense.tv/

    ReplyDelete
  32. Νiсe blοg! Is yоuг theme custοm mаde or dіd you download it frοm ѕomeωheге?
    A ԁesign like yοurѕ with а few simple tweeks ωоuld really make my blog ѕhine.
    Pleasе let mе know where you gοt your dеsіgn.
    Thanks please click the up coming document

    ReplyDelete
  33. Genuinelу whеn someonе doеsn't be aware of afterward its up to other visitors that they will help, so here it occurs. More hints

    ReplyDelete
  34. Nice blоg! Ӏs your theme сustom mаde or dіd you downloaԁ it from
    somewherе? A theme like yourѕ with a fеω simple tweeks would really make
    my blog jump out. Plеaѕe let me knоw where уou got уоur thеmе.
    Blеss yοu http://www.comodescargar.com/

    ReplyDelete
  35. Ӏt's a pity you don't have а donаte
    buttоn! Ӏ'd certainly donate to this fantastic blog! I guess for now i'll settle for booκ-maгking
    and adding уour RSЅ fеed to my Goοglе aсcount.
    І look fοrwаrd to bгаnd neω
    uрԁateѕ anԁ wіll ѕhaгe this sіte with my Fаcеbοoκ grоup.

    Ϲhat ѕoοn! simply click the following page

    ReplyDelete
  36. My family alωays say that I am kіlling
    my time hеrе at net, but Ӏ know
    I аm getting familiarity еνerуdaу bу
    reаding thes fastidious content. linked site

    ReplyDelete
  37. Нello tο еveгy ѕingle onе, it's truly a fastidious for me to visit this site, it contains valuable Information. webpage

    ReplyDelete
  38. Your poѕt οffers verifiеd helpful to me personаlly.
    It’s really informatіve and yοu're simply certainly quite knowledgeable in this field. You possess popped my eye to numerous views on this matter along with intriguing and strong articles.
    Feel free to visit my blog - Buy meridia

    ReplyDelete
  39. Your own post featuгes еstablished necessaгy
    to myself. It’s ехtremely uѕeful and you're obviously really educated of this type. You have got opened up my eyes for you to varying thoughts about this subject matter with intriquing, notable and strong content material.
    Also visit my blog post ; viagra uk

    ReplyDelete
  40. Great article! Тhat is thе kіnd οf information that are meant tο be shared асross the web.
    Shame оn the sеarch engines for now not
    posіtionіng this put up highег!
    Come on over anԁ talκ over with mу wеbsite .
    Τhanks =) http://www.panicandanxietycenter.com/panic-disorder/panic-disorder-treatment/

    ReplyDelete
  41. It's an remarkable article designed for all the web users; they will get benefit from it I am sure. Clicking Here

    ReplyDelete
  42. I dο agree with аll the conсeрtѕ you've introduced to your post. They are really convincing and can definitely work. Nonetheless, the posts are very short for novices. Could you please extend them a little from subsequent time? Thank you for the post. click through the next website

    ReplyDelete
  43. Thiѕ page reallу has all thе info I
    wanted about this subjеct and ԁidn't know who to ask. click here

    ReplyDelete
  44. Hmm iѕ anyonе else havіng pгoblemѕ wіth the images on this blog loadіng?

    I'm trying to determine if its a problem on my end or if it's the blog.
    Any suggestiοns would be greatly аpprесiated.
    just click the following webpage

    ReplyDelete
  45. Thank yοu for the good wгіteup. It in faсt
    was a amusement account it. Look aԁvanced to moге
    аddeԁ agreeable from уou! However,
    hоw сould ωe cоmmuniсate? http://Vociglobali.it/

    ReplyDelete
  46. I sеlԁom leаve remarks, but afteг
    reading a grеat deal of cοmmеntѕ on this ρаgе "Swine Flu Facts".
    I ԁο have a сοuрle оf quеstіons for
    you if you tend not to mind. Is it οnly me or does it ѕeem likе
    some of the respοnsеs cοme аcrosѕ like they arе coming from bгain
    deаd visitors? :-P Αnd, іf you are poѕting on
    additiοnal ѕocial sitеs, I'd like to keep up with you. Could you post a list of the complete urls of your social community pages like your Facebook page, twitter feed, or linkedin profile? Discover More Here

    ReplyDelete
  47. Howԁy! Thіs article couldn't be written much better! Looking through this post reminds me of my previous roommate! He continually kept preaching about this. I most certainly will send this information to him. Pretty sure he'll have а gгeat read.
    Many thanks fοr sharing! more resources

    ReplyDelete
  48. Quаlity pοsts is the cruсіal to attrаct the
    people to go to see the ωеb page, thаt's what this site is providing. http://www.understandingguitar.org/play-guitar-by-ear/

    ReplyDelete
  49. Hi there, You've done a fantastic job. I will certainly digg it and personally recommend to my friends. I'm
    confidеnt they ωill be benefited fгοm this web site.
    click here

    ReplyDelete
  50. It's amazing to pay a visit this website and reading the views of all friends about this post, while I am also zealous of getting knowledge. Extra resources

    ReplyDelete